Disparities in Reported Reasons for Not Initiating or Stopping Antiretroviral Treatment Among a Diverse Sample of Persons Living with HIV

Johnson, Mallory O.; Chesney, Margaret A.; Neilands, Torsten B.; Dilworth, Samantha E.; Remien, Robert H.; Weinhardt, Lance S.; Wong, F. Lennie; Morin, Stephen F.

doi:10.1007/s11606-008-0854-z

Cited by 23 publications

(19 citation statements)

References 18 publications

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“…59 Other studies have also observed suboptimal treatment utilization in minority groups. 2,36,60,61 These findings reinforce the importance of eliminating health disparities by increasing services to provide early and equal access to health care for low-income persons living with HIV=AIDS. 62 The results of this study must be interpreted in light of the following limitations.…”

Section: Discussionmentioning

confidence: 71%

Utilization of Medical Treatments and Adherence to Antiretroviral Therapy among HIV-Positive Adults with Histories of Childhood Sexual Abuse

Meade

Hansen

Kochman

et al. 2009

AIDS Patient Care and STDs

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Section: Discussionmentioning

confidence: 71%

Utilization of Medical Treatments and Adherence to Antiretroviral Therapy among HIV-Positive Adults with Histories of Childhood Sexual Abuse

Meade

Hansen

Kochman

et al. 2009

AIDS Patient Care and STDs

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“…7 Finally, there is evidence that potential side effects impact acceptance of offered medication 8 and our own research 9 suggests that side effect concern is a primary reason for discontinuing ART among HIV+ individuals. While researchers are actively attempting to identify new treatment agents that have fewer side effects, the goal of a completely side effect-free, clinically effective regimen has not yet been developed.…”

Section: Introductionmentioning

confidence: 95%

Mindfulness-Based Stress Reduction for HIV Treatment Side Effects: A Randomized, Wait-List Controlled Trial

Duncan

Moskowitz

Neilands

et al. 2012

Journal of Pain and Symptom Management

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Context Advances in antiretroviral therapy (ART) for HIV offer life-extending benefit; however, the side effects associated with ART use negatively impact quality of life and medication adherence among people living with HIV. Objectives This study tested the efficacy of mindfulness-based stress reduction (MBSR) for reducing ART symptoms and bother/distress related to ART side effects. Secondary aims were to test the impact of MBSR on medication adherence and psychological functioning. Methods Seventy-six people living with HIV who were actively taking ART and reported distress from ART-related side effects were randomly assigned to MBSR or a wait-list control standard care condition. We measured side effects, ART adherence, perceived stress, depression, positive and negative affect, and mindfulness at three time points: baseline, three-month follow-up, and six-month follow-up. Side effects and related distress were assessed separately from other symptoms. Results Compared to a wait-list control, participants in the MBSR condition experienced a reduction in the frequency of symptoms attributable to antiretroviral therapies at three months post intervention (mean difference = 0.33; 95% confidence interval [CI] = 0.01, 0.66; t(132) = 2.04, P = 0.044) and at six months post intervention (mean difference = 0.38; 95% CI = 0.05, 0.71; t(132) = 2.27, P = 0.025). MBSR participants also experienced a reduction in distress associated with those symptoms at three months post intervention (mean difference = 0.47; 95% CI = 0.003, 0.94; t(132) = 1.99, P = 0.048) compared with the wait-list control condition. Conclusion Mindfulness-based stress reduction is a promising approach for reducing HIV treatment-related side effects.

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“…PLHA may not perceive the need for ART, particularly when they feel healthy (18). African-American and Latino/Hispanic PLHA evidence a number of HIV- and health care-related attitudes and beliefs rooted in culture and U.S. history.…”

Section: Introductionmentioning

confidence: 99%

HIV-Infected Individuals Who Delay, Decline, or Discontinue Antiretroviral Therapy: Comparing Clinic- and Peer-Recruited Cohorts

Gwadz

Applegate

Cleland

et al. 2014

Front. Public Health

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A substantial proportion of persons living with HIV/AIDS (PLHA) delay, decline, or discontinue antiretroviral therapy (ART) when it is medically indicated (40–45%), largely African-Americans and Latinos/Hispanics. This study explores the feasibility of locating PLHA, who are not on ART (PLHA-NOA) through clinics and peer-referral; compares the two cohorts on multi-level barriers to ART; and examines readiness to initiate/reinitiate ART, a predictor of treatment outcomes. We recruited adult HIV-infected African-American and Latino/Hispanic PLHA-NOA through HIV hospital clinics and peer-referral in 2012–2013. Participants were engaged in structured 1-h assessments with reliable/valid measures on barriers to ART. We found that recruitment through peers (63.2%, 60/95) was more feasible than in clinics (36.8%, 35/90). Participants were 48.0 years old and had lived with HIV for 14.7 years on average, and 56.8% had taken ART previously. Most (61.1%) were male and African-American (76.8%), and 23.2% were Latino/Hispanic. Peer-recruited participants were older, had lived with HIV longer, were less engaged in HIV care, and were more likely to have taken ART previously. The cohorts differed in reasons for discontinuing ART. Levels of ART knowledge were comparable between cohorts (68.5% correct), and there were no differences in attitudes toward ART (e.g., mistrust), which were in the neutral range. In bivariate linear regression, readiness for ART was negatively associated with physician mistrust (B = −10.4) and positively associated with self-efficacy (B = 5.5), positive outcome expectancies (B = 6.3), beliefs about personal necessity of ART (B = 17.5), and positive internal norms (B = 7.9). This study demonstrates the feasibility of engaging this vulnerable population through peer-referral. Peer-recruited PLHA evidence particularly high rates of risk factors compared to those in hospital clinics. Interventions to support ART initiation and continuation are sorely needed for both subgroups.

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Disparities in Reported Reasons for Not Initiating or Stopping Antiretroviral Treatment Among a Diverse Sample of Persons Living with HIV

Cited by 23 publications

References 18 publications

Utilization of Medical Treatments and Adherence to Antiretroviral Therapy among HIV-Positive Adults with Histories of Childhood Sexual Abuse

Utilization of Medical Treatments and Adherence to Antiretroviral Therapy among HIV-Positive Adults with Histories of Childhood Sexual Abuse

Mindfulness-Based Stress Reduction for HIV Treatment Side Effects: A Randomized, Wait-List Controlled Trial

HIV-Infected Individuals Who Delay, Decline, or Discontinue Antiretroviral Therapy: Comparing Clinic- and Peer-Recruited Cohorts

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